Research Progress on the Potential Mechanisms and Multimodal Management of Psychocardiological Disease

Q: What is the clinical evidence from this study?

Study design: Review. Population: Psychocardiological Disease (coronary artery disease, acute coronary syndrome, heart failure with anxiety and depression). Intervention: Multimodal management.

Q: What does this research mean for the field?

Cardiovascular diseases and psychological conditions such as anxiety and depression share a complex bidirectional relationship driven by multiple physiological mechanisms, necessitating integrated, multimodal management approaches. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

Hao Zhang; Yating He; Bei Zhang; Wenwen Zhang; Haijun Xu

doi:10.3791/72808

September 8, 2026Journal of Visualized Experiments

Research Progress on the Potential Mechanisms and Multimodal Management of Psychocardiological Disease

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Key result

Review highlights the bidirectional link between CVD and psychological distress and outlines multimodal management strategies.

Why the study?

Cardiovascular disease frequently coexists with anxiety and depression in a bidirectional relationship that worsens clinical outcomes, necessitating an overview of mechanisms and multimodal management strategies.

Key Points

To review the bidirectional relationship between cardiovascular disorders and psychological distress, exploring underlying biological mechanisms and integrated multimodal therapeutic strategies.
Synthesized literature on the epidemiology, pathophysiology, and management of comorbid anxiety and depression across coronary artery disease, acute coronary syndrome, and heart failure.
Evaluated integrated multimodal interventions encompassing cardiology care, psychotherapy, pharmacotherapy, exercise rehabilitation, and digital monitoring.
Identified critical shared pathophysiological mechanisms connecting heart disease and psychological disorders, including autonomic and neuroendocrine dysregulation, systemic inflammation, mitochondrial dysfunction, altered gut microbiota, and disrupted heart-brain communication.
Demonstrated that comorbid anxiety and depression worsen cardiovascular prognosis and impair treatment adherence, while cardiovascular disease events simultaneously induce or aggravate psychiatric symptoms.
Highlighted the necessity of moving beyond single-specialty care to combined paradigms involving risk stratification, structured psychological therapies, physical rehabilitation, and biomarker identification.

Structured PICO

P

Population

Patients with coronary artery disease, acute coronary syndrome, and heart failure coexisting with anxiety and depression

I

Intervention

Integrated approaches involving cardiovascular treatment, psychological interventions, exercise rehabilitation, pharmacotherapy, social support, and digital management

Integrated multimodal management is essential for addressing the complex bidirectional relationship between cardiovascular disease and psychological conditions like anxiety and depression.

Implication

Supports multimodal management for comorbid CVD and psychological distress; leaves open validation via prospective RCTs.

Abstract

Cardiovascular disease frequently coexists with anxiety and depression, creating a complex bidirectional relationship between mental and cardiovascular health. Anxiety and depression may increase cardiovascular risk, impair treatment adherence and self-management, and contribute to poorer long-term outcomes. Conversely, acute cardiovascular events, persistent physical symptoms, and functional limitations may trigger or exacerbate psychological distress. This narrative review focuses on coronary artery disease, acute coronary syndrome, and heart failure, and summarizes the epidemiological associations, clinical implications, potential mechanisms, and management strategies related to anxiety and depression. The mechanisms discussed include neuroendocrine and autonomic dysregulation, inflammation, mitochondrial dysfunction, gut microbiota alterations, and heart-brain communication. The review also examines integrated approaches involving cardiovascular treatment, psychological interventions, exercise rehabilitation, pharmacotherapy, social support, and digital management. Future research should standardize diagnostic criteria and outcome measures, clarify key mechanistic pathways, develop clinically meaningful phenotypic classifications, identify useful biomarkers, and evaluate comprehensive interventions in multicenter studies. These efforts may strengthen early detection, risk stratification, individualized treatment, and long-term management for patients with coexisting cardiovascular and mental health conditions.

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Cite This Study

Zhang et al. (2026) conducted a review in Psychocardiological Disease (coronary artery disease, acute coronary syndrome, heart failure with anxiety and depression). Multimodal management was evaluated. This narrative review summarizes the bidirectional relationship between cardiovascular disease and psychological distress, detailing mechanisms and integrated multimodal management strategies.

synapsesocial.com/papers/6aa27b0c58559d80afc74166 https://doi.org/10.3791/72808